Four Years Later: Reflections On The Covid Pandemic

Lissa Rankin, MD
6 min readMar 28, 2024

It’s hard to believe it’s been four years since the world stopped. I’ll never forget the terror I felt when I saw the spooky, surreal, apocalyptic images of Times Square completely empty. I remember vividly the tears that flowed when the strictest part of San Francisco’s early lockdown first eased up, and I went to the San Rafael farmer’s market with a mask on, expecting to buy some produce. That’s when I really got how much the world had changed while I’d been holed up in West Marin in our sheltered little coastal village. There was hardly anyone at the farmer’s market, and the people who were there weren’t making eye contact or laughing or socializing at all. We were robots on a mission. Get your lettuce, pay with no touching and no cash, and then get out of dodge. My privileged little bubble had been broken, and I felt awash in shame.

A year later, the ferries had started running again, so I took an almost empty ferry to San Francisco to the farmer’s market at the Ferry Building. It was practically deserted. San Francisco had emptied out during the pandemic. All those ambitious, young tech bros got lonely all by themselves in their studio apartments and went back to wherever they came from once it didn’t help their careers to be schmoozing over coffee every day.

I remember vividly the one year anniversary of the day the WHO called it a pandemic. It was the day I first got to see one of my best friends, who was a front line Covid ER doc. He wouldn’t see me for a whole year, even though he’s one of my closest friends, because he feared infecting me and never forgiving himself if something happened to me. I saw him for the first time since Covid started on the one year anniversary, right after he’d been one of the first to get vaccinated, since he was a front line physician.

That day when I met up with him on Stinson Beach, the song from Rent, Seasons of Love, kept running through my mind. “525,600 minutes…how do you measure, measure a year.”

I found out later that day that we’d lost 525,000 Americans to Covid by that point. One American per minute- and the majority of them were those with the fewest privileges, the BIPOC, the chronically ill, the poor, the essential workers those of us in lockdown relied upon for survival, the elderly. As a lifelong Civil Rights activist, it was a social justice nightmare- and heartbreaking.

It wasn’t lost on me that the Rent song that kept ringing in my ears was also about an epidemic- the AIDS epidemic. We lost about 40 million people to AIDS, but that was over a fifty year period. The 1918 flu pandemic killed between 20 and 50 million. We lost 7 million to confirmed Covid deaths. But we lost 30 million altogether if you count both Covid deaths and trauma-related, pandemic-related deaths, such as suicide, murder, drug and alcohol related deaths, and missed doctor’s appointments or hospitalizations for other illnesses.

It’s hard to grok all that loss and feel it in our hearts and our bones.

What has made it all the more maddening is that much of the confirmed Covid death loss, at least in the United States, was preventable. We had one of the highest Covid death rates in the US, especially after vaccines became available. Because about 30% of Republicans still have not gotten vaccinated- and less than 10% of Democrats have refused vaccination- and because we now have very clear scientific proof that vaccinations save lives, Covid deaths skewed politically, with far more Covid deaths in states that voted for Trump in 2020 than those who voted for Biden. Recently, about 95% of Covid-related hospitalizations happened among people who willfully refused vaccination.

Lives aren’t all we lost. Kids are still recovering from the social, educational, and mental health impacts of school closures. My daughter graduates high school this year, so I’ve had an up close and personal lens on her and her peers. The developmental delay resulting from pandemic losses is obvious- and none of it was anyone’s fault. It just sucks. Their lives may be forever impacted by what pandemic kids endured. As one of my friends says whenever I tell him something awful, “Ain’t that some shit.”

Those of you reading this post, we are the ones who survived. I don’t know about you, but I do have some survivor’s guilt. I know that part of why I survived is because of many unearned privileges. The privilege of being white and therefore less traumatized by our culture and therefore at lower risk from the chronic nervous system dysregulation and chronic inflammation in the body caused by systemic trauma. The socioeconomic privilege of being able to lock down and socially distance, with only four people in a house with four bedrooms- and none of us essential workers bringing the virus back to the home. The privilege of being straight, cis-gender, and without underlying medical conditions. The privilege of being well educated and an entrepreneur who can do my work from lock down on the internet. The privilege of having left front line hospital work in 2007 to become a writer and online educator. The privilege of being middle-aged, not elderly, and of having rapid access to vaccination once it was my turn. The privilege of critical thinking- and having a medical education that made me capable of discerning Covid misinformation and propaganda from actual science. The privilege of having enough mental health and nervous system privilege to avoid falling down Covid-related rabbit holes that ran rampant in spiritual circles, like Covid denialism and apocalyptic conspiracy theories that turned liberals into “Trump is a lightworker” far right wing radicals singing the praises of white supremacist “spiritual white women” posing as angel channelers.

All this makes me uncomfortable with my privilege. But I’m also grateful to have survived, to have the chance to spend a few more decades on this planet in crisis, to watch my daughter grow up and go to college, to do the work that I love, to write another book, to finally launch my health equity-related trauma healing non-profit Heal At Last (which got derailed by the pandemic), to hopefully grow old with my partner Jeff, and now that it’s safer, to travel to some exciting destinations this year.

The gratitude offsets some of the survivor’s guilt. It’s not my fault that I was born with unearned privileges or that I didn’t die during Covid, but it is my responsibility to leverage those privileges and my survival ethically. As such, we will be launching an online version of our first beta testing pilot of the Heal At Last group very soon.

If you haven’t heard about it yet, Heal At Last is a wide distribution, health-equity aware, peer-supported delivery system for trauma healing and resilience building for those who struggle to afford or access effective trauma therapy or other trauma healing recovery programs. We will begin on Zoom and then begin building in person small group gatherings once we’ve beta tested the Zoom model.

So stay tuned for that, and make sure you’re on my mailing list if you want to be notified when we’re ready to launch. I’ll post the link in the comments below.

Until then, we made it, y’all. Four years. None of us are the same. Many are still struggling from pandemic-related losses, mental health challenges, the financial impact of the pandemic, long Covid, and other trauma symptoms. But we’re still here.

Spring is coming, and the daffodils and cherry blossoms are blooming in my neck of the woods. The California poppies are popping up on roadsides, and the first of the spring wildflowers are beginning to blossom on the hiking trails I frequent. Thousands of people showed up in Union Square in San Francisco on Saturday to receive 15 free tulips in honor of International Women’s Day- and it was the exact opposite of how Union Square looked four years ago. Signs of recovery are popping up everywhere.

This is my favorite time of year, even though it’s now a reminder of March 2020, when the world stopped.

I’d love to hear YOUR memories. What do you remember from this time four years ago? Tell us on Facebook here.

Warmly,

Lissa

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Lissa Rankin, MD

Lissa Rankin, MD, New York Times bestselling author of Mind Over Medicine, The Fear Cure, and The Anatomy of a Calling.